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. 2015 Jan 9;2015(1):CD006962. doi: 10.1002/14651858.CD006962.pub2

Comparison 6. Ultrasound guidance vs anatomical landmarks for internal jugular vein cannulation for central vein catheterization and experienced operators.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Complication rate total 8 1532 Risk Ratio (M‐H, Random, 95% CI) 0.29 [0.19, 0.43]
1.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture 5 1357 Risk Ratio (M‐H, Random, 95% CI) 0.30 [0.19, 0.46]
1.2 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Indirect puncture 1 40 Risk Ratio (M‐H, Random, 95% CI) 0.33 [0.13, 0.86]
1.3 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. No detail on whether direct or indirect puncture 2 135 Risk Ratio (M‐H, Random, 95% CI) 0.03 [0.00, 0.50]
2 Overall success rate 9 2513 Risk Ratio (M‐H, Random, 95% CI) 1.11 [1.06, 1.16]
2.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture 6 2138 Risk Ratio (M‐H, Random, 95% CI) 1.11 [1.05, 1.16]
2.2 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Indirect puncture 2 280 Risk Ratio (M‐H, Random, 95% CI) 1.10 [0.92, 1.31]
2.3 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. No detail on whether direct or indirect puncture 1 95 Risk Ratio (M‐H, Random, 95% CI) 1.29 [1.11, 1.51]
3 Number of attempts until success 7 2029 Mean Difference (IV, Random, 95% CI) ‐1.09 [‐1.52, ‐0.66]
3.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture 5 1894 Mean Difference (IV, Random, 95% CI) ‐1.04 [‐1.54, ‐0.54]
3.2 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Indirect puncture 1 40 Mean Difference (IV, Random, 95% CI) ‐0.65 [‐1.17, ‐0.13]
3.3 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. No detail on whether direct or indirect puncture 1 95 Mean Difference (IV, Random, 95% CI) 0.00 [‐2.78, ‐1.22]
4 Arterial puncture 10 2632 Risk Ratio (M‐H, Random, 95% CI) 0.27 [0.17, 0.44]
4.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture 8 2477 Risk Ratio (M‐H, Random, 95% CI) 0.23 [0.15, 0.36]
4.2 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Indirect puncture 2 155 Risk Ratio (M‐H, Random, 95% CI) 0.80 [0.22, 2.90]
5 Haematoma formation 8 2477 Risk Ratio (M‐H, Random, 95% CI) 0.20 [0.08, 0.50]
5.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture 8 2477 Risk Ratio (M‐H, Random, 95% CI) 0.20 [0.08, 0.50]
6 Time to successful cannulation 7 2073 Mean Difference (IV, Random, 95% CI) ‐31.90 [‐76.07, 12.28]
6.1 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture. Time between penetration of skin and aspiration of venous blood into the syringe 3 1694 Mean Difference (IV, Random, 95% CI) ‐28.59 [‐35.01, ‐22.17]
6.2 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture. Time of beginning of localization of the vessel up to aspiration of venous blood 1 84 Mean Difference (IV, Random, 95% CI) ‐1.0 [‐26.56, 24.56]
6.3 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture. Time from completion of skin preparation and draping to successful aspiration of venous blood into the syringe 1 80 Mean Difference (IV, Random, 95% CI) 68.57 [59.59, 77.55]
6.4 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. Direct puncture. Time required for successful guide wire insertion 1 120 Mean Difference (IV, Random, 95% CI) ‐92.00 [‐145.74, ‐42.26]
6.5 Traditional landmark vs ultrasound guidance for internal jugular vein cannulation for central vein catheterization. No detail on whether direct or indirect puncture. Time between insertion of needle into the skin until free flow of blood from the catheter 1 95 Mean Difference (IV, Random, 95% CI) ‐588.0 [‐839.32, ‐336.68]